PHW deliver, monitor and evaluate seven national population-based screening programmes and coordinate the all-Wales managed clinical network for antenatal screening.
Infection Services in PHW cover all aspects of infections and infectious diseases including: Fungal disease, Cryptosporidium, Antimicrobial resistance and stewardship, Anaerobic infections (e.g. Clostridium difficile (C.diff)), Respiratory infections, Molecular diagnostics, Genomics, Toxoplasma and Blood-borne viruses.
PHW responds to communicable disease challenges in Wales by providing services including the; Communicable Disease Surveillance Centre, Vaccine and Preventable Disease Programme and Environmental public health services. Health protection aims to eliminate significant public health problems in Wales including Hepatitis B, Hepatitis C, HIV and Tuberculosis and employs methods such as record linkage and infectious disease modelling.
Improving Uptake of Screening Services and Reducing Inequity in Uptake
1. What outcomes arise from the exploration of innovative screening approaches, such as self-sampling, within cervical screening programmes to reduce inequity?
2. What tailored interventions can be developed using behavioural science to effectively address persistent or non-attenders in screening initiatives to reduce inequity?
Improving Screening Through Use of New Technology
1. What are the impacts and outcomes of incorporating artificial intelligence into breast screening and diabetic eye screening processes?
2. What are the potential uses and benefits for genomics approaches (e.g., newborn sequencing, liquid biopsy) in the delivery of new and existing screening services? What evidence is required to begin to move genomics from the research lab into screening services in Wales?
Screening and Genetic Links
1. How do individuals with a recognised genetic predisposition to cancer engage in screening behaviours, and what implications does this behaviour have on health inequalities?
2. What are the ethical considerations, acceptability, and feasibility of implementing population screening for genetic conditions?
Example Questions for Infection Services
1. What are the effective interventions for achieving the elimination of blood borne viruses?
2. What factors serve as drivers for fungal disease and what role do antifungals play in managing these diseases?
3. What are the plausible transmission routes for the strains of Clostridium difficile (C.diff) infection observed post-COVID-19? Are these routes connected to food, laundry, staff, ambulances, a combination of factors, or yet-to-be-identified cryptic routes?
4. Can a correlation be established between reductions in antimicrobial usage and reductions in specific resistances?
5. How can food testing methods be developed specifically for gastrointestinal protozoan parasites, with a focus on parasites like Cryptosporidium?
6. How might culture free genomic approaches improve the delivery of diagnostic services in areas including Sexually Transmitted Infections (STIs) and Tuberculosis (TB)? How might the advent of such approaches create opportunities to re-imagine the delivery of current services?
7. What is the basis for the observed increases in rates of Gonorrhoea? To what extent are these related to better ascertainment?
Communicable Disease and Environmental Hazards
1. What are the key social determinants that contribute to the prevalence and spread of communicable diseases in settings such as schools, care homes and prisons?
2. What are the barriers hindering access to and engagement in infectious disease (ID) screening and treatment among health inclusion groups (e.g. those experiencing homelessness, migrants and refugees)?
3. How effective is a contact tracing approach in controlling the spread of Hepatitis C?
4. What are the health impacts associated with poor outdoor air quality, and how effective are interventions, such as the implementation of 20mph zones, in mitigating these health risks?
5. What are the multifaceted impacts of the 20mph legislation implementation in Wales?
6. What does an ‘appropriate’ genomic surveillance system look like and what level of sequencing resolution is required to provide effective population-level surveillance, and to provide confidence for public health action?
7. How can advanced genomic epidemiological analysis approaches such as phylodynamics, be introduced into routine use in Wales?
8. Where does wastewater surveillance fit as part of an integrated surveillance system in Wales? What are its unique features, and how do these compliment established parts of the existing system?
9. How can wastewater, testing and genomic data be used to develop an improved blueprint for infectious disease and environmental hazard surveillance?
10. How does effluent discharge influence the presence of gastrointestinal (GI) pathogens in leisure waters, and what is the correlation with the incidence of GI cases?
Evaluation of Vaccine Programmes
1. What specific interventions are required to achieve a noticeable population-level improvement in the vaccination rates for specific diseases?
2. What are the determinants of under-vaccination and what targeted interventions are needed to overcome them?
3. How are public attitudes and knowledge of vaccinations changing over time and does how vaccine literacy influence uptake?
One Health Approaches - The interaction between the health and wellbeing of people or Climate change:
1. What specific interventions are essential for effectively managing pandemics that involve both human and animal components?
2. What comprehensive systems are required to enhance the monitoring of human and animal disease causing organisms across Wales and how can these systems provide pandemic preparedness and mitigate the impacts of climate change, particularly with respect to zoonotic disease? How can these systems be designed to take into account geographical factors, host genomic factors and health inequalities?